Anastomotic dehiscence
is one of the most serious complications following surgery for colorectal
cancer, and early detection of anastomotic dehiscence is critical to minimize
mortality and morbidity. The aim of this study was to determine the value of
peritoneal interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) as
markers for preclinical detection of anastomosis dehiscence following
colorectal surgery. Concentrations of IL-6 and TNF-α were measured in drain
fluid obtained from 58 patients on days 1 to 4 following surgery for colorectal
cancer. Five out of 58 patients developed anastomosis dehiscence. Patients who
developed anastomosis dehiscence had significantly higher concentration of IL-6
on day 1 after surgery, and TNF-α on day 1, 2 and 4 after surgery.
Interleukin-6 on day 1 was predictive for anastomosis dehiscence with
specificity of 83%, sensitivity of 80%, positive predictive value (PPV) of 31%
and negative predictive value (NPV) of 98%. TNF-α was predictive for
anastomosis dehiscence on day 1 (specificity 92%, sensitivity 80%, PPV 50%, NPV
98%), day 2 (specificity 94%, sensitivity 80%, PPV 57%, NPV 98%), and day 4
(specificity 83%, sensitivity 100%, PPV 27%, NPV 100%). Our study indicates the
potential use of peritoneal cytokines IL-6 and TNF-α as additional diagnostic
tool for early detection of anastomosis dehiscence following colorectal
surgery.